Victims of muscular dystrophy or cerebral palsy, as well as persons who by reasons of other diseases or injury become paraplegics or quadriplegics, require supportive seating systems. In order to have the requisite ability to perform useful tasks, many such individuals utilize a variety of wheelchairs in which they frequently spend many hours at a time. Many such individuals are children when they are first afflicted, hence their seating systems have to be adapted to suit their changing needs as they grow. Older individuals who experience weight loss or gain may also require modification of the seating system.
While numerous supportive systems for wheelchairs are available, the highly specific nature of such needs often requires that the solution be highly customized, convenient for the handicapped user and reasonable both in immediate and long term costs. Over the years, two well known approaches have developed. One approach is to combine modular, preformed, adjustable elements to provide the specific support desired. The second approach utilizes individual components, molded to fit a particular patient. While both approaches provide seating systems that, in general, can be adapted to suit a variety of conventional user-propelled wheelchairs, travel chairs and the like, each approach has its own limitations and problems.
One example of the first approach is the STC II Custom System, marketed by the STC Custom Systems of Elyria, Ohio, which comprises literally hundreds of support devices, such as various sizes and shapes of pads, cushions, backs, foot plates and straps, head supports, knee abductors, shoulder harnesses, lumbar supports and custom-built seats, from which particular elements are selected and combined for mounting in a wheelchair to suit an individual. This system evidently relies on a selection from a large number of differing shapes and sizes of finished support members to "custom-fit" the user. Another system using this approach is the MED MPI seating system for children with cerebral palsy, by Medical Equipment Distributors, Inc., originally developed under the University of Tennessee Rehabilitation Engineering Program, Memphis, Tenn., which employs adjustable modular components selected after a trial fitting in an evaluation and measuring frame in which the user's measurements are taken to determine which preformed plastic components should be selected. The MED MPI system allows clinicians to experiment with various positions with a particular child to take measurements for the finalized support position, after which these measurements are forwarded to a supply source which, in turn, provides the specific components for final fitting.
One example of the second approach is the Foam In Place (FIP) seating system from Carapace, Inc., of Tulsa, Okla., also developed by the University of Tennessee, which employs a two-component polyurethane foam mixture molded to the individual patient's lower body and upper body separately to make customized seat and back components for installation in a conventional wheelchair frame. Another example of this approach is the CONTOUR U (.TM.) seating system by Pin Dot Products, of Chicago, Ill., in which a simulation frame holds two rubber bags filled with plastic beads - one bag for the back, one for the seat. The clinician can adjust the back-to-seat angle, and the length and angular orientation in space to find the optimum seating position. The bags can be shaped and reshaped as needed and then, using a vacuum, locked in place. Plaster bandages are then applied to the bags to give a positive, permanent copy of each mold. A layer of waterproof upholstery is vacuum formed over each mold and a liquid foam is injected to form the stuffing, so that the foam fills the complex curves exactly, forming a seat that mirrors the patient's body. Some adjustment is provided in the Pin Dot product so that the back and seat may be individually adjusted, e.g., to suit a growing child whose legs grow longer.
While the first approach has the advantage of speed in fitting the patient from numerous preformed components, it lacks the ability to provide the highly customized fitting necessary for a person who has to spend many hours, without the freedom to change his position very much. Such a system usually leads to problems with undue pressure on sensitive spots of the user's body, bed sores and the like. While this system may be cost efficient, it is not necessarily suitable for most users for prolonged use. The second approach inherently provides for highly customized shaping of the supportive elements of the seating system, but the actual fitting tends to be time consuming, expensive and not amenable to significant adjustment after initial formation.
A need exists, therefore, for a customized seating system, suitable for use with conventional wheelchairs and the like, that combines the cost-effectiveness of modular components with highly individualized personal fitting of the final product to a particular user's needs.